Twelve‐year follow‐up of conservative management of postnatal urinary and faecal incontinence and prolapse outcomes: randomised controlled trial
Abstract
Objective: To determine the long‐term (12‐year) effects of a conservative nurse‐led intervention for postnatal urinary incontinence. Design: Follow‐up of a randomised controlled trial. Setting: Community‐based intervention in three centres (in the UK and N ew Z ealand). Population: A cohort of 747 women with urinary incontinence at 3 months after childbirth, of whom 471 (63%) were followed up after 12 years. Methods: Women were randomly allocated to active conservative treatment after delivery (pelvic floor muscle training and bladder training), or to a control group receiving standard care. Main outcome measures: Prevalence of urinary incontinence (primary outcome) and faecal incontinence, symptoms and signs of prolapse, and performance of pelvic floor muscle training at 12 years. Results: The significant improvements relative to controls that had been found in urinary incontinence (60 versus 69%; risk difference, RD , −9.1%; 95% confidence interval, 95% CI , −17.3 to −1.0%) and faecal incontinence (4 versus 11%; RD −6.1%; 95% CI −10.8 to −1.6%) at 1 year did not persist for urinary incontinence (83 versus 80%; RD 2.1%; 95% CI −4.9 to 9.1%) or faecal incontinence (19 versus 15%; RD 4.3%; 95% CI −2.5 to 11.0%) at the 12–year follow up, irrespective of incontinence severity at trial entry. The prevalence of prolapse symptoms or objectively measured pelvic organ prolapse also did not differ between the groups. In the short term the intervention motivated more women to perform pelvic floor muscle training (83 versus 55%), but this fell in both groups by 12 years (52 versus 49%). Conclusions: The moderate short‐term benefits of a brief nurse‐led conservative treatment for postnatal urinary incontinence did not persist. About four‐fifths of women with urinary incontinence 3 months after childbirth still had this problem 12 years later.
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A 12-year follow-up of an RCT comparing PFMT with control found no effect of PFMT on symptoms or prevalence of POP.
“A 12-year follow-up of an RCT comparing PFMT with control found no effect of PFMT on symptoms or prevalence of POP [57].”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [57]
The evidence for a positive effect in the postpartum period is not supported by results from Bø et al. (2015) or the 12-year follow-up of conservative management of postnatal urinary and fecal incontinence and POP outcomes by Glazener et al. (2014).
“Additionally, the evidence for a positive effect in the postpartum period is not supported by results from Bø et al. (2015) [54] or the 12-year follow-up of conservative management of postnatal urinary and fecal incontinence and POP outcomes by Glazener et al. (2014) [57].”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [57]
Cites
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“A 12-year follow-up of an RCT comparing PFMT with control found no effect of PFMT on symptoms or prevalence of POP [57].”
Background
- Authors
- Glazener, C., MacArthur, C., Hagen, S., Elders, A., Lancashire, R., Herbison, G., Wilson, P., & The ProLong Study Group
- Affiliations
- University of Aberdeen (GB)
- University of Birmingham (GB)
- Glasgow Caledonian University (GB)
- Department of Preventive and Social Medicine Dunedin School of Medicine University of Otago Dunedin New Zealand
- University of Otago (NZ)
- Corresponding author
- Glazener, CMA
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2013-10-22
- Volume
- 121
- Issue
- 1
- Pages
- 112-120
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2008367017
- Cited by
- 64
- References
- 21
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 5 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 4 · 2019: 7 · 2018: 8 · 2017: 6 · 2016: 6 · 2015: 8 · 2014: 4
- FWCI
- 4.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- ResearchOnline (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
- Keywords
- fecal incontinence, pelvic organ prolapse, pelvic floor muscle training, bladder training, nurse-led intervention, conservative treatment, long-term outcomes, postpartum women
- MeSH terms
- Adult, Exercise Therapy, Fecal Incontinence, Female, Humans, Longitudinal Studies, Urinary Incontinence, Treatment Outcome, Delivery, Obstetric, Postpartum Period, Young Adult, Pelvic Organ Prolapse, Practice Patterns, Nurses'
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